Blood Clot in the Uterus

Question:

"I'm eight weeks pregnant. Recently, after an ultrasound, my doctor told me that I had a uterus blood clot and put me on light duty (no exercising, etc.). He didn't give me any further information, but told me to see him again in two weeks. Should I be worried?"

Isn’t it ironic how some of the most joyful moments of modern pregnancy — like catching a glimpse of your budding babe in an early pregnancy ultrasound — can inspire so much angst? Before the days of sophisticated medical imaging, countless women sailed through seemingly perfect pregnancies, producing perfect little people, without ever knowing they had complications like a uterus blood clot. But now you can find out, and so you worry — very often without cause.

Most of the blood clots that turn up on sonograms during the first trimester are what doctors call subchorionic hematomas. In plain English, that means a clump of clotted blood situated between the gestational sac in which your baby is nestled and the wall of your uterus. Uterus blood clots are no different from those anywhere else in the body: They form from coagulated blood cells and proteins. To have one, you must have been bleeding in your uterus at some point, which is much less ominous than it sounds. Small bouts of bleeding are quite common during early pregnancy, and as long as the pregnancy is progressing nicely, you’re at no higher risk.

What caused the uterus blood clot? It’s hard to be certain. It may have been a ruptured blood vessel, or the placenta may have pulled slightly away from the uterine wall (a condition called a placental abruption). Over time, the clot may be reabsorbed into the uterus, or it may just loiter around harmlessly until your baby is born. On your follow-up visit, your doctor will likely perform another ultrasound to find out.

In the meantime, to be on the safe side, heed your doctor’s advice and take it easy. That way, you’ll reduce the risk that the uterus blood clot will dislodge and lead to more bleeding. No heavy lifting or straining; no strenuous exercise. Your doctor may also put your pelvis off-limits to vaginal exams (and, sadly, pregnancy sex). Get as much bed rest as possible — consider it a well-deserved breather (brewing a baby is exhausting business!)— and, most importantly, put the worrying on the back burner.

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